Taking Multiple Pain Relievers May Cause Complications

THURSDAY, Feb. 21 -- People who take more than one nonsteroidal anti-inflammatory drug (NSAID) may have poorer health-related quality of life, a U.S. study suggests.

NSAIDs, which are available in both prescription and over-the-counter (OTC) forms, are commonly used to treat arthritis.

These drugs are widely available, and patients may take both prescription and OTC NSAIDs at the same time, either because they need more pain relief or because they don't realize the products belong to the same class of drugs, said the study authors, who added that doctors may not know their patients are taking more than one NSAID.

This study, led by Stacey H. Kovac of Durham VA Medical Center and Duke University in North Carolina, included 138 patients enrolled in a large regional managed-care organization. All of the patients had filled at least one NSAID prescription between February and August 2002.

The researchers found that 26 percent of the patients reported taking at least two NSAIDs (prescription, OTC or both) during the previous month. These dual users scored lower than others on the physical component of a questionnaire designed to evaluate physical and mental health.

Keeping a complete list of a patient's medications would help doctors identify patients who are taking more than one NSAID, the study authors said.

"The increased awareness may lead to better communication between the patient and provider about the appropriate use of NSAIDs," they wrote.

Patients who take more than one NSAID may do so because of inadequate clinical pain management or because they have higher levels of pain than other patients, said the researchers. Future research should examine factors that may lead to dual NSAID use and methods of identifying patients taking two or more NSAIDs and may be at higher risk of adverse side effects from the drugs.